通过质性研究探讨减重手术后患者居家饮食管理困境。

运用描述性质性研究，采用目的抽样法选取2024年1月至10月于广州市暨南大学附属第一医院复诊的减重手术后患者进行半结构式访谈，运用Colaizzi现象学资料七步分析法进行资料分析。

归纳出减重手术后患者进食模式被动改变，缺乏主观能动、对减重手术不切实际的期待、患者对术后饮食管理的认知偏差（对术后饮食管理的重视程度逐渐降低、对食物的认知误差、对食物量的认知偏差）、术后饮食管理的影响因素（促进因素、阻碍因素）4个主题、5个亚主题。患者主观能动、对减重手术、术后饮食管理、食物选择、食物量等的认知对减重手术后饮食管理具有重要作用；影响患者术后饮食管理的促进因素包括家人陪伴、体重敏感、外界环境限制、医务人员警示、同伴竞争；阻碍因素可归总为主观因素和客观因素：主观因素包括生活方式、对食物的渴望、情绪调节困难、压力状态以及自暴自弃心理；客观因素包括患者的职业、社交压力。

医务人员应关注减重手术后患者的饮食体验，为患者制定个性化的饮食指导，提高其饮食依从性，进而维持手术的远期疗效。

To explore the dilemma of home diet management in patients after bariatric surgery using qualitative study.

A descriptive nature study was used to select patients who were revisited from January 2024 to October 2024 at the First Affiliated Hospital of Jinan University in Guangzhou using an objective sampling method for semi-structured interviews, and the data were analyzed by Colaizzi phenomenological data 7-step analysis method.

The study concluded that bariatric surgery led to passive changes in patients' eating patterns. There were 4 themes and 5 sub-themes: lack of subjective initiative, unrealistic expectations for bariatric surgery, patients' cognitive bias towards postoperative diet management (gradually decreasing emphasis on postoperative diet management, cognitive error of food, and cognitive bias of food quantity), and influencing factors (promoting factors and hindering factors) of postoperative diet management. Patients' subjective initiative, cognition of bariatric surgery, postoperative diet management, food selection, and food quantity play an important role in postoperative diet management. The factors influencing postoperative diet management included family accompaniment, weight sensitivity, external environment restriction, medical staff warning, and peer competition. Hindrance factors can be summarized as subjective and objective factors: subjective factors include lifestyle, food cravings, emotional adjustment difficulties, stress, and self-abandonment psychology; Objective factors include the patient's occupational and social pressure.

Medical staff should pay attention to the dietary experience of patients after bariatric surgery and formulate personalized dietary guidance for patients to improve their dietary compliance and maintain the long-term effects of surgery.